Hepatic arterial infusion chemotherapy (HAIC) significantly improves survival outcomes in advanced hepatocellular carcinoma vs. transarterial chemoembolization (TACE). HAIC improves overall survival (OS) by 49% and progression-free survival (PFS) by 45%. Key prognostic factors for better outcomes with HAIC include male gender, AFP <400 ng/ml, vascular invasion, and HBV positivity. Consider HAIC especially for patients with […]
Category: HPB & Spleen
Robotic Right Hepatectomy Sets New Benchmarks for Surgeons
New benchmarks for robotic right hepatectomy (RRH) show it may outperform traditional laparoscopic and open techniques. 357 patients analyzed; 172 were low-risk benchmark patients. Key reference values for surgical performance: operative time ≤476 min, conversion rate ≤8.2%, major complications ≤23.1%. Robotic RRH shows lower conversion and complication rates compared to laparoscopic and open approaches, suggesting […]
Endoscopic ultrasound enhances gallbladder tumor diagnosis
Endoscopic ultrasound (EUS) effectively distinguishes between malignant and benign gallbladder wall thickening, improving surgical decision-making. EUS achieved a sensitivity of 79.31% and specificity of 92.86% for diagnosing gallbladder tumors. Key indicators of malignancy included wall thickness greater than 14 mm and disrupted wall layers; both are highly significant (p < 0.001). Surgeons should consider EUS […]
Augmented Reality Enhances Liver Resection Outcomes
Augmented reality in liver surgery reduces intraoperative bleeding and complications. Blood loss decreased by 75.9 ml (p < 0.001) with AR guidance. Transfusion rates dropped to nearly half (RR: 0.47; p = 0.01); fewer complications (RR: 0.64; p = 0.009). AR-assisted techniques could improve surgical precision and patient outcomes, particularly in tumor cases. Tumor recurrence […]
Effective Suturing for Bile Leaks in Laparoscopic Hepatectomy
A new suturing technique using LapraTy® suture clips shows promise for managing intraoperative bile leaks during laparoscopic surgery. Rapid closure of bile leaks without excessive tension is possible, reducing risk of tissue damage. Omental coverage may help prevent postoperative bile leakage and improve outcomes. This technique is particularly valuable in challenging surgical situations and enhances […]
Minimally Invasive Surgery Gains Ground in Pancreatic Cancer
Minimally invasive surgery (MIS) is being validated for pancreatic cancer, impacting how surgeons approach patient selection and procedures. 22 out of 28 statements on MIS received over 90% expert agreement, enhancing surgical guidance. The consensus includes recommendations for left pancreatectomy, pancreatoduodenectomy, and total pancreatectomy tailored for cancer. Surgeons can adopt these evidence-based practices to improve […]
Elra Improves Survival in Hepatic Echinococcosis with CTPV
Elra, or ex vivo liver resection and autotransplantation, offers a promising solution for patients with hepatic alveolar echinococcosis facing cavernous transformation of the portal vein. No intraoperative mortality in both treatment groups; 90-day mortality was 16.7%. Long-term survival for CTPV patients undergoing elra was 72.9%, compared to 29.6% for those treated conservatively. The data supports […]
New Criteria for Surgical Resection in Advanced Pancreatic Cancer
Surgeons can now better assess resectability in pancreatic cancer by focusing on specific vascular targets. Introducing a clear definition: “suitable target” vessels determine anatomic resectability, improving clarity in patient selection. Emphasizes the importance of 3D CT imaging and intraoperative assessment of vascular isolation for successful reconstruction. Adopting this approach enhances surgical eligibility evaluations and has […]
New Guidelines for Splanchnic Venous Thrombosis Post-Splenectomy
Splanchnic venous thrombosis is a critical yet often overlooked risk after splenectomy in hematologic patients. Incidence is 11.4%, rising to 20.7% with routine imaging and 15.1% in single-center studies. Major risk factors include splenic size and weight; age, BMI, and platelet count were not significant. Patients with myeloproliferative neoplasms, lymphoma, and thalassemia face the highest […]
Predicting Recurrence in Lymph Node-Negative Pancreatic Tumors
A new risk score for lymph node-negative pancreatic neuroendocrine tumors helps identify patients at risk for recurrence and guides postoperative surveillance. Recurrence rate for lymph node-negative patients was 10.6%, occurring at a median of 32.4 months post-surgery. Risk factors included male sex (2.2x), tumor size ≥3 cm (2.64x), grade 2 or higher (3.70x), and lymphovascular […]